Altercare Coshocton Inc.

Inspectors wroteBased on medical record review, podiatrist note review, facility contract review, policy review, the American Association of Diabetes Standards of Diabetic Care 2025 and Cleveland Clinic web resource review, and facility staff and resident interviews the facility failed to ensure routine podiatry services and toenail trimming were provided to Resident #11 every one to three months as recommend by the American Diabetic Association Standards of Diabetic Care 2025 for individuals at high risk for development of diabetic ulcers. This affected one resident (#11) of three residents reviewed for activities of daily living. The facility census was 71.

Inspectors wroteBased on observation, interview and record review, the facility failed to properly store food products to prevent contamination. The facility also failed to maintain a clean, sanitary environment to prevent contamination of food prepared in the kitchen. This had the potential to affect 68 residents who consumed food from the kitchen. The facility census was 71.

Inspectors wroteBased on record review, observation and interview the facility failed to prepare food by methods that conserve nutritive value, flavor, and appearance. This had the potential to affect four (#36, #68, #3, and #33) of four residents identified by the facility to be ordered pureed diets. The facility census was 71.

Inspectors wroteBased on record review and interview, the facility failed to ensure the resident or resident representative was informed in advance of the risks and benefits of the proposed care, the treatment alternatives or other options and was able to choose the option he or she preferred. This affected one (#10) of five residents reviewed for unnecessary medications. The facility census was 71.

Inspectors wroteBased on medical record review, resident financial record review, staff interview/email communication, and facility in-service documentation review, the facility failed to ensure all resident funds were placed in an interest-bearing account. This affected one (#44) of five residents reviewed for financial accounts. The census was 71.

Inspectors wroteBased on medical record review, resident financial record review, staff interview/email communication, and facility in-service documentation review, the facility failed to ensure all resident funds were not co-mingled in other facility accounts. This affected one (#44) of five residents reviewed for financial accounts. The census was 71. Findings Include:Record review revealed Resident #44 was admitted to the facility on [DATE]. [...]

Inspectors wroteBased on medical record review, Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNF ABN) review, policy review and interview, the facility failed to ensure residents were offered and documented their decision in regards to continuation of skilled therapy services and their inpatient stay at the facility as required. This affected two residents (#53, #60) of three residents sampled. The census was 71.

Inspectors wroteBased on record review, observation, and interview, the facility failed to maintain a clean and sanitary environment. This affected one resident (#22) of three residents observed for skin treatments. The census was 71.

Inspectors wroteBased on medical record review, observation and interview, the facility failed to review baseline care plans with newly admitted residents within the required timeframe. This affected one resident (#81) of four newly admitted residents sampled. The census was 71.

Inspectors wroteBased on observation, medical record review, policy review and interview, the facility failed to provide nail care to a dependent resident. This affected one resident (#22) of three residents sampled for activities of daily living (ADL). The census was 71.

Inspectors wroteBased on medical record review, policy review and interview, the facility failed to provide adequate care and services related to the treatment of constipation, preventative measures for urinary tract infections, and post-operative treatment of hip surgery. This affected two residents (#22, #81) of seven residents reviewed for quality of care and treatment. The facility census was 71.

Inspectors wroteBased on observation, record review, and review of facility policy, the facility failed to implement an adequate and effective pressure ulcer prevention program to prevent the development of pressure ulcers. This affected one (#83) of three residents reviewed for pressure ulcers. The facility census was 71.

Inspectors wroteBased on record review, observation and interview, the facility failed to provide oxygen to a resident at the flow rate ordered by the physician. This affected one (#10) of three residents reviewed for respiratory concerns. The facility census was 71.

Inspectors wroteBased on medical record review, resident interview, staff interview, and facility policy review, the facility failed to have a proper parameters for as needed pain medication. Also, the facility failed to acquire pain medication in a timely manner for a resident who had documented pain. This affected two (#1, #81) of three residents reviewed for pain management. The census was 71.

Inspectors wroteBased on record review, staff interview, and policy review, the facility failed to ensure a resident's medical record was complete and accurate to reflect an advanced level provider (nurse practitioner) was notified and an order was received for a resident to be released from the facility AMA (against medical advice) and accuracy of treatment recommendations for medications. This affected two (#22, #74) of nine residents reviewed for accuracy of medical records.

Inspectors wroteBased on observation, medical record review, policy review and interview, the facility failed to maintain adequate infection control practices during a skin treatment. This affected one resident (#22) of two residents observed for wound treatments. The census was 71.

Inspectors wroteBased on observation, interview, and policy review, revealed the facility failed to ensure foods were labeled and not kept past the expiration date. Additionally, the facility failed to ensure unit refrigerators, containing resident food, were kept clean. This had the potential to affect all 63 of 63 residents who consumed food. The facility identified two residents (#10 and #35) who received nothing by mouth. The facility census was 65.

Inspectors wroteBased on record review and interview the facility failed to ensure Resident #6, who had a history of weight loss, was provided supplements as ordered. This affected one resident (#6) of two residents reviewed for nutrition. The facility census was 65.

Inspectors wroteBased on observation, staff interview and policy review the facility failed to ensure appropriate food storage was maintained to prevent contamination. This had the potential to affect 65 of 67 residents residing in the facility. The facility identified two residents (Residents #11 and #52) who received nothing by mouth.

Inspectors wroteBased on record review and staff interview the facility failed to notify residents and/or resident representatives when individual resident funds accounts reached two hundred dollars less than the allotted Medicaid resource limit. This affected seven residents (#2, #4, #5, #6, #14, #21, and #42) of 41 residents with resident fund accounts. The facility census was sixty-seven.

Inspectors wroteBased on personnel record review, job description review and staff interview, the facility failed to employ a qualified Activity Director. This had the potential to affect all 67 residents residing in the facility.